NHS treatment algorithms ‘not taking transgender patients into account’

A host of algorithms used by medics to assess disease risk and help make decisions on treatment are failing to take transgender patients into account, doctors have said.

Many metrics and thresholds in medicine, including ideal body weight, alcohol clearance rates, kidney function and risk of cardiovascular disease vary by gender.

A team of UK doctors and medical students have issued a warning over a lack of evidence as to whether trans patients should be considered for these gender-based scores according to their gender assigned at birth or the gender they have transitioned to – or whether alternative scores are required.

In an effort to tackle the issue, the team have launched a research initiative called Trans Gap Project.

Dr Michael Niman, a junior NHS doctor and chair of the project, said: “Currently, daily medical decisions involving gender-based scores have limited to no research for the trans community. This means that trans patients are often forgotten about or not considered in the medical world, leading to a significant gap in their access to appropriate medical care.”

“When scores that haven’t considered trans people are used, patient autonomy is impaired for trans and gender-diverse patients, as they can’t make true informed decisions on their care – which is one of the bioethic pillars,” Niman said.

In some cases, there could be safety concerns. “Clinicians are currently faced with uncertainty regarding the best clinical practice to address these scenarios, owing to a lack of evidence-based guidance,” Niman said. “It is vital clinicians take a vested interest in the research of gender-based scores for the trans community due to the importance of safe practice considerations within the NHS.”

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Source: The Guardian, 5 May 2023